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Division of Pensions & Benefits

School Employees' Health Benefits Program

Eligibility for Retired Group SEHBP coverage is available to qualified retirees of local education employers, as determined by the State Health Benefits Program.

Information for Plan Year 2021

Information for Plan Year 2022

Aetna Medicare Advantage Plans

Medicare Advantage plans, sometimes referred to as "Part C" or "MA plans," provide Medicare Part A (inpatient hospital insurance) and Medicare Part B (outpatient medical insurance) coverage. The Aetna MA plans offer access to providers nationwide, with the same benefits in or out of network, and no referrals required.

SEHBP Medicare-eligible retirees can enroll in the following Aetna Medicare Advantage plans: Aetna Educators Medicare Advantage 10 and Aetna Educators Medicare Advantage Plan 15 (SEHBP); Aetna Medicare Advantage HMO 10; and Aetna Medicare Advantage HMO 1525.

Spouse or Partner with Different Medicare Eligibility than the Member

Medicare-eligible retirees enrolled in a non-Medicare Advantage plan and who have a spouse or partner who is not Medicare eligible will move to the Aetna MA plan while the spouse/partner and/or any covered children remain in the non-Medicare-Advantage plan. Similarly, retirees who are not eligible for Medicare but have a spouse or partner who is Medicare eligible will remain in their non-Medicare-Advantage plan (along with any covered children) while the spouse/partner is transferred to the Aetna MA plan.

Retiree prescription drug coverage is included with retired group medical plan enrollment. OptumRx is the pharmacy benefits administrator for all Retired Group members of the SEHBP.

Medicare Plan Rates for retirees enrolled in Private Medicare Part D Plans are available by request to the NJDPB's Office of Client Services

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Last Updated: Friday, 10/22/21